When Do Babies Start Teething? Signs & Symptoms

Your baby’s first tooth and those adorable toothy grins are milestones you’ll look for and treasure. If you’re wondering when they will appear, it’s good to know that the timing of teething varies widely from baby to baby. Read on to discover when your baby may start teething, the signs and symptoms of teething, how long teething typically lasts, and much more.

When Do Babies Start Teething?

Teething often starts when babies are between 6 and 12 months old, though in some cases those first teeth may appear earlier or even a little later. In some very rare cases newborns may be born with a tooth already erupted, or have a tooth come through in the first few weeks.

What if Teething Starts Later Than You Expect?

It’s helpful to remember that growing teeth is not a competitive sport, and that your baby’s teeth will arrive when they are ready. So, don’t be concerned if your friends’ children get teeth before your baby does.

The age range can be quite broad when it comes to teething. Though it’s likely that teething may begin between 6 and 12 months, the first tooth may appear as early as 3 or 4 months or as late as 14 months. Some babies might even be slightly outside of this range on either side. Genetics may play a role in the timing.

Of course, if you’re concerned about your baby’s teeth (or lack thereof) or have any questions about dental care, speak to her healthcare provider or dentist.

Which Teeth Come in First?

How Long Does Teething Last?

The duration of the teething process can vary. At some point between your child’s second and third birthdays, however, your little one will have a full set of 20 primary teeth. This means the total teething period lasts about two years.

If your little one has teething discomfort, know that this will probably come and go. Teething symptoms are typically experienced in the days before a tooth erupts; then the soreness subsides until a new tooth starts to come in.

How Many Baby Teeth Will Appear in Total?

Your little one’s first set of teeth are known as primary or baby teeth. By the time she’s 2 and a half to 3 years old she will have a full set of 20 baby teeth.

When your child is around 6 or 7 years old, the baby teeth will start falling out to make way for her permanent teeth, sometimes called secondary teeth. It takes many years for all 32 secondary teeth to come in, so for a while there your child will have a mix of primary and secondary teeth.

Signs and Symptoms of Teething

As the baby teeth grow and break through the gums, teething symptoms can include:

• Irritability. Your little one might seem a little fussier and may cry more than usual.

• Disturbed sleep. Teething pain or discomfort may cause your baby to wake up during the night.

• More drooling. It’s common for a teething baby to drool a lot when teething. Experts say the extra saliva can help soothe the tender gums.

• Chewing on things. When your baby is teething, she may gnaw on toys, a teething ring, or even her own fingers to help relieve the pressure she feels on her gums. Chewing on something firm helps massage the gums and helps ease any discomfort as the tooth tries to erupt.

• Sore, swollen gums. The spot where a tooth is coming through may be tender, red, and swollen.

• Low-grade temperature. During teething, your little one’s temperature may be slightly elevated, but teething is unlikely to cause a fever higher than 101 degrees Fahrenheit. If your baby seems very uncomfortable or has a temperature of at least 101 degrees (or at least 100.4 degrees for a baby under 3 months) , contact your little one’s healthcare provider, who can determine what’s causing the fever.

Teething Timeline

Top Teeth

• Central incisors (the front teeth): 8 to 12 months

• Lateral incisors (the teeth on either side of the front teeth): 9 to 13 months

• Canines, or cuspids (the sharp, pointy teeth on either side of the lateral incisors): 16 to 22 months

• First molars (the back teeth used to grind food): 13 to 19 months

• Second molars (the back teeth that fill in the last gaps): 25 to 33 months

Bottom Teeth

• Central incisors (the front teeth): 6 to 10 months

• Lateral incisors (the teeth on either side of the front teeth): 10 to 16 months

• Canines, or cuspids (the sharp, pointy teeth on either side of the lateral incisors): 17 to 23 months

• First molars (the back teeth used to grind food): 14 to 18 months

• Second molars (the back teeth that fill in the last gaps): 23 to 31 months

How to Soothe Your Teething Baby

Teething can be uncomfortable for some babies, and as there’s no magic technique that works for every child, you may have to experiment to find something that helps your little one feel better. Among the many ways to soothe your teething baby are these two quick ideas:

• Give a teething ring. Chewing on one of these rings lets your teething baby massage her own gums. Some types can be cooled in the fridge to give extra relief, but don’t put a teething ring in the freezer—this can make it too hard and cold for your little one’s sensitive gums. To keep your little one safe, never tie a teething ring to a string that’s looped around your baby’s neck or clipped to her top.

• Massage your baby’s gums. Using a clean finger, gently massage your baby’s sore gums.

How to Care for Your Baby’s New Teeth

It’s important to start caring for your baby’s teeth (or tooth) as soon as the first one pokes through. Those baby teeth have to last several years before they’re replaced with adult teeth, and establishing good dental hygiene habits early on will help set your little one up for healthy teeth and gums throughout her life.

Taking steps to prevent cavities and tooth decay in the baby teeth is just as important as it is with adult teeth, because decay in these teeth can affect the permanent teeth that follow and cause other dental problems like pain and infections.

Brushing Your Baby’s Teeth

Regular brushing is an important part of dental care. The key thing at this stage is to gently clean baby teeth twice a day and to get your little one used to the brushing routine.

Here are some guidelines for brushing your baby’s teeth, as well as some tips on teaching your older child how to get the job done, with your help:

• Brush at least twice a day, always brushing after your child has had anything sugary as well as after the last meal or drink of the day

• Put a tiny smear of fluoride toothpaste on a soft-bristled toothbrush designed for your baby’s age. Carefully brush each tooth, making sure to reach all the surfaces, including the sides and the inside surface. Once your child is about 2 years old you can start using a pea-sized amount of fluoride toothpaste. You’ll need to teach him how to rinse and spit, rather than swallowing the toothpaste.

• The direction of the brush stroke doesn’t really matter. The key is to clean each tooth from all angles, making sure you reach the back teeth as well

• For now you’ll need to brush your baby’s teeth. As he reaches the toddler and preschooler stage, help him begin brush his own teeth, under your close supervision. You’ll need to lend a hand until he’s 7 or 8 years old to ensure those teeth get a thorough clean. Here are some ideas for how to make brushing more fun for both of you.

Diet

Your little one’s diet is a big part of dental health. Avoid giving your child sugary drinks like fruit juice and sodas, or sticky sweet snacks like gum, toffee, and sticky caramel. Also, don’t let your baby fall asleep with a bottle or sippy cup of milk, formula, juice, or any other sweet drink, as this can cause the sugary liquid to pool in his mouth and lead to tooth decay.

For more on caring for your baby’s teeth, check out our article on dental care for children.

Dental Checkups

Getting professional care from a dentist is crucial for the healthy development of your child’s teeth, mouth, and gums. Usually, the first dentist visit should take place within about six months of the first tooth poking through or by the time your child is 12 months old, whichever comes first.

Of course, if you have any questions or concerns, you can make an appointment at any time. Your baby’s healthcare provider will also check your baby’s teeth and gums at his regular well-child checkups.

When to See Your Baby’s Healthcare Provider

If your little one is showing symptoms like fever, irritability, or diarrhea, or any other signs of childhood illness, and you’re not sure whether it’s related to teething or something else, it’s safest to call your healthcare provider so an accurate diagnosis and treatment plan can be made.

You should also contact your baby’s healthcare provider if you’re concerned about how much discomfort your baby is in as a result of teething. The provider may recommend some form of pain relief while also making sure that nothing else is wrong to cause the elevated levels of pain or discomfort. Do not use teething gels to numb the gums, as these are dangerous.

You’ll also want to consult your baby’s healthcare provider or dentist if your baby has a tooth problem or injury, such as a broken or chipped tooth.

Interesting Facts About Baby Teeth

Want to know more about teething and those white-as-can-be baby teeth? Here are some fun facts about your little one’s teeth:

• On average, about four teeth will poke through every six months during the teething process

• Girls’ teeth may erupt a little sooner than boys’ teeth

• The bottom teeth tend to erupt before the same type of tooth on the top

• Teeth usually erupt in symmetrical pairs; in other words, one tooth on the right side of the jaw and the same type of tooth on the left side of the jaw will poke through at roughly the same time

• Your child’s primary teeth are smaller and whiter than the permanent teeth that will replace them in a few years’ time

• From around the age of 4, your child’s face and jaw will begin to grow and change shape, and this will create gaps in his smile as the baby teeth won’t catch up in size. This is completely normal—it’s the mouth’s way of making space for the bigger adult teeth that will follow.

• Your baby’s secondary teeth will be coming in when he is about 7 or 8 years old. Because it will take a little while before your child has a full set of adult teeth, for several years your child will have a mix of baby and adult teeth.

• Your baby has 20 primary teeth but will have many more secondary teeth. By the time your child is in his teens or early 20s, he’ll have between 28 and 32 adult teeth.

The Bottom Line

Teething can sometimes be a challenging time for your baby and you. Try to keep in mind how important those teeth are, helping your child chew and bite into the nutritious foods that are fueling his growth and development.

If you’re still waiting for that first tooth, know that it will be here soon enough, and more will be on the way. Each new tooth that emerges will make that smile even more adorable than it was before.

Take good care of your baby’s tiny teeth and before you know it the gaps in your little one’s smile will be filled in with some of the cutest, whitest teeth you’ve ever seen!

Your guide to teething month by month | Baby & toddler articles & support

Here we look at the different stages of teething, from when to expect the first symptoms, to when they might be sporting a full set of pearly whites.

This is one area of your baby’s life that you’re allowed to wish away and hurry to get past: teething. After all, who likes seeing their baby in pain? And teething does cause little ones a lot of discomfort (Eisenstadt et al, 2017).

“The first thing to say is teething is a completely normal and, unfortunately, a necessary stage in your baby’s development.”

It usually starts to happen when they’re six to nine months old. Your baby will likely be more unsettled than usual, with excess drool and wanting to chew everything in sight (Harding, 2016). See our article on the signs of teething.

Teething: when does it happen?

Your baby’s milk teeth first teeth start to develop when they’re in the womb (Community Practitioner, 2011). We know, mind-blowing. But the teeth usually pop through the gums during your baby’s first year (Community Practitioner, 2011; American Dental Association, 2018).

That said, some babies are born with their first teeth and others don’t see any come through until after 12 months. As with all things baby, there are no hard and fast rules. By the time your baby’s two and a half to three years old though, they will more than likely have a full set of teeth (Family Lives, 2018).

How many teeth should my baby have and when?

A rough rule of thumb is that the age of your baby in months minus six gives the average number of teeth, up to the age of 2 years (Ashley, 2001). For example a baby hitting their first birthday will have around 12 (months) minus six – so six teeth.

So what exactly is going on in there?

The gums swell and are tender to touch just before a tooth breaks through (Ashley, 2001) and so anything in their mouths could cause additional pain.

You might see their gum start to split slightly to make way for the emerging tooth (Harding, 2016; NHS, 2016). This is actually the cells in the gum over a tooth dying off, creating a path for the tooth to emerge through (Community Practitioner, 2011).

And with the molars (and occasionally the incisors) you can see a blistering on the gum or a smooth bluish swelling ahead of the tooth emerging (Ashley, 2001).

Mind the gap

When the teeth grow, special chemicals are released by the body. This causes part of the gums to separate and allow teeth to grow through. How clever is that? (Harding, 2016; NHS, 2016).

What’s the order that baby teeth appear in?

Here’s a quick, handy chart that tells you roughly when to expect each tooth, though do remember that every child is different (NHS, 2016; NHS Devon, 2018). Generally, you’ll find their teeth erupt in pairs, usually starting with their two bottom teeth – first incisors (Lyttle et al, 2015).

Don’t be alarmed, teething isn’t constant from five to 33 months. In fact, each tooth or pair of teeth should only cause your little one pain for just over a week. In other words, for five days ahead of an appearance – ‘eruption day’ – and three days afterwards (Macknin et al, 2000).

So what can I do to help them through these bouts of teething?

Teething may make them super-grumpy, which is tough on you too. Thankfully, there are some things that can ease their discomfort, such as teething toys, certain foods and even cuddles. You can read more about teething in our range of articles.

“And rest assured that like with every stage, this one will pass. Soon you’ll be on to the daily teeth cleaning battles…”

See our guide to brushing your baby’s teeth here.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT’s Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

NHS has produced a guide to looking after your baby’s teeth.

NCT has partnered with the British Red Cross to offer courses in baby first aid.

Teething in a child: signs, how to understand how to help

Teething in an infant is a very exciting moment in the life of the baby and his parents. And although teething is a physiological process, almost all children experience discomfort and anxiety during this period. From the point of view of a scientific approach to this problem, the difficulty lies in the fact that with all the variety of symptoms of teething from mild anxiety and moodiness, increased salivation to an increase in body temperature to high numbers and signs of impaired digestion, increased colic and diarrhea, there are no sufficient diagnostic criteria to associate all these numerous symptoms with the root cause. Nevertheless, until now, many parents and part of practicing pediatricians are ready to blame teething in an infant for almost all the troubles that fall on their head in the period from 5 to 6 months to one and a half to two years, when the process of teething is mainly teeth should already be completed.

For most babies, teething begins between the ages of 4 and 7 months. As a rule, the eruption of each tooth lasts from 2 – 3 to 8 days. During this time, an increase in body temperature to 37.4 – 38.0 degrees is possible. At the same time, high (from 38.0 and above) temperature usually lasts no more than 2 days. Discharge from the nose during the period when the teeth erupt, usually, are transparent, liquid, and should not contain pathological impurities: pus, greenery, etc. Teething cough is caused by saliva entering the nasopharynx and larynx, which is secreted in large quantities. Treatment of cough on the background of teething does not require. Pediatricians sometimes disagree on diarrhea, with some noting that diarrhea (loose stools) is not directly related to teething. And yet, studies have shown that 10 to 30% of children have frequent and/or loose stools during teething. This is also explained by the large amount of saliva secreted, which increases intestinal motility.

Teething or infection

Nevertheless, most modern pediatricians agree that such symptoms in an infant as: prolonged, over 2 – 3 days diarrhea, cough, vomiting, fever (body temperature rise above 38.5 degrees) are most often caused by infection, and not just teething teeth. Therefore, for any of the above symptoms, it is necessary to examine the child by a pediatrician, and only after other causes of an increase in body temperature are excluded, efforts should be concentrated on helping the baby to reduce discomfort from teething.

Teething, how to help the baby

This may require a fair amount of patience. In such a difficult period, you should often take the baby in your arms, caress, distract from unpleasant sensations with toys, turn on pleasant, soothing music, you can sing if natural data allows. A walk in the fresh air can also have a calming effect. Breastfeeding children, during teething, begin to cry and ask for breasts more often, and a loving mother needs to be patient, putting the baby to the breast every time, even if it grabs the areola of the nipple more than usual during feeding. To satisfy the child’s need to chew and hold something in his mouth, you can naturally use special rubber rings or toys, the so-called teethers. You can offer your child a dryer or baby cookies.

Currently, pharmaceutical companies offer a wide range of different products, primarily in the form of gels for “soothing the gums”. Basically, most of these products contain painkillers such as lidocaine. It is not worth it to abuse these funds. They are not completely harmless, the anesthetics that make up them can have an adverse effect on the nervous and cardiovascular systems of the child, and most importantly, they can cause serious allergic symptoms, exacerbate atopic dermatitis (diathesis) in children predisposed to allergies. In connection with the foregoing, I can recommend, to reduce swelling and inflammation of the gums during teething, such special dental anti-inflammatory drugs for topical use as cholisal gel, which can be applied to the baby’s gums 2-3 times a day, but it must be rubbed (not strongly of course) with light massaging movements over the entire surface of the gums, and not just put it in the child’s mouth.

In addition, you can give a child suffering from teething, special homeopathic drops, such as Dantinorm baby, according to the instructions for the drug. In any case, when the disturbing symptoms appear, which are described above in this article, I advise you to play it safe once again and call a pediatrician to a child with a high temperature. Your diagnosis and recommendations should be given by a professional.

Symptoms of teething in children under one year old and ways to alleviate them

In the first year of life, the child develops rapidly. He learns to sit, crawl, walk. And he also has something that indicates the general physiological development, the maturation of the digestive system. He is preparing to move from feeding exclusively on milk or formula to a new stage – to the use of semi-solid and solid foods and the appearance of the first milk teeth .

The eruption of the first milk teeth is influenced by genetic characteristics, health, nutrition and other factors. Even the dependence of teething in infants on the region of residence has been established. So, in the northern regions of Russia, there is a frequent deviation from the average terms towards a later eruption of ^[1] .

On average, the first baby tooth appears at 6-7 months. Within three years, all 20 milk teeth will take their place in the dentition. In some babies, teething begins at 4-5 months, someone waits up to 10-12 months. All this is the normal range of ^[2] .

There are several theories explaining the process of teething ^[2] :

• Hunter’s theory – pushing a tooth out of the bone alveolus occurs due to the pressure of growing roots;

• Yasvoin’s theory – the appearance of a tooth above the gum provokes processes of differentiation in the tissue of the dental papilla;

• Katz’s theory – an increase in tissue pressure in the area of ​​the bottom of the alveoli directs the tooth to the surface.

But none of them can fully explain this complex mechanism.

By the time of tooth eruption, the area of ​​bone covering the crown of the tooth has been resorbed. The same processes are noted in the gum. During the growth of the tooth root, the bone is also rebuilt and the dental alveoli gradually deepen. At the same time, morphological changes in the tissues surrounding the tooth occur: increased blood flow, changes in vascular permeability, increased production of the main substance of the pulp and periodontium

“Can the physiological process of teething in infants be pathological?” Doctor of Medical Sciences, Professor, Chief Pediatrician of the Central Federal District of the Russian Federation, Honored Doctor of the Russian Federation Zakharova I. N. ^[2]

It is not surprising that the appearance of teeth causes discomfort in children at any age, but this process is especially difficult for babies.

Symptoms of teething in a child

The appearance of milk teeth is a natural physiological process, however, a number of children develop a symptom complex, which, according to the International Classification of Diseases, is classified as teething syndrome (ICD code – K00.7). Numerous surveys of young children say that the most common symptoms accompanying the appearance of teeth are:

• increased salivation — processes in the oral cavity are activated;

• irritability – the child experiences severe discomfort and cannot report it otherwise than by changing behavior;

• sleep disturbance – the pain is so severe that the baby cannot sleep or wakes up frequently during the night;

• itching of the gums – children try to compensate for it by trying to bite the breast or nipple, by trying to keep hands, toys, clothes in their mouths.

Such harbingers of the appearance of a tooth occur in 35-60% of children. But some babies may have non-specific symptoms ^[2] :

On average, symptoms appear 5-8 days before the appearance of a tooth. When teething several teeth at the same time, this, as a rule, increases the discomfort.

Even if the child’s symptoms are very similar to those of teething, a specialist consultation is necessary. Be sure to consult a doctor if diarrhea or fever persists for a long time.

Ways to alleviate discomfort

To ease teething in a baby, it is necessary to:

• provide additional attention and care from parents;

• if the child is breastfed, breastfeed more frequently as this has a slight sedative effect;

• purchase several silicone teethers that can be cooled and offered to the baby during the day;

• massage the gums with a finger wrapped in a clean gauze pad or with a special silicone nozzle;

• blot drool in time with a clean tissue to avoid irritation of the skin around the mouth;

• if necessary and in agreement with the doctor, use medicines.

Today, there are pharmacological and non-pharmacological methods of therapy for the eruption of temporary teeth.

Topical preparations

Pediatricians prescribe gels and ointments as symptomatic relief for severe discomfort associated with teething.

These teething gels and ointments with proven effectiveness are divided into 3 groups ^[1] :

• Anesthetic-based analgesics (lidocaine, choline, benzocaine). Sometimes lidocaine-based preparations include anti-inflammatory or antiseptic components, providing a combined effect of the gel.

• Medicines based on anti-inflammatory or antiseptic agents.

• Preparations based on extracts of medicinal plants. They use extracts of Roman chamomile, boswellia, aloe, marshmallow, Indian ivy, medicinal rhubarb, calendula and other components of plant origin.

Homeopathic teething products are also produced, but their effectiveness has not been scientifically proven ^[1] .

Systemic drugs

In severe pain syndrome, hyperthermia, non-steroidal anti-inflammatory drugs are used, which reduce body temperature and have a systemic analgesic effect. The pediatrician should select the dosage and the drug suitable for the child.

Distractions

These include: the gum massage described above and baby teethers that help your baby temporarily relieve itchy gums.

Inspection of erupted teeth

Swelling and redness of the gums gradually subside as the infant’s teeth erupt and grow, but should be monitored. Normally, the teeth should be evenly located in the dentition, not have whitish or colored spots, irregularities on the enamel.

Violation of the timing, pairing and sequence of eruption of milk teeth can serve as a marker of various diseases and disorders. For example, rickets or hypothyroidism ^[2] . It is important to record the date of appearance of each tooth and its location in the mouth. It is convenient to do this with photos saved in a separate folder on your smartphone.

Erupted Tooth Care Instructions

To clean baby’s teeth, use special silicone fingertips with soft bristles. Toothpaste should be labeled as suitable for young children and free of substances that are harmful if swallowed: high concentrations of fluoride, parabens, sodium lauryl sulfate.

As soon as the first tooth shows above the gum line, it needs special care . Enamel has not yet fully formed, it is very thin, so children’s caries develops rapidly. Only 10% of children manage to avoid caries and adults practically fail ^[5] . Therefore, do not postpone the preventive fight against it.

To maintain the health of milk teeth, some of which will remain with the child until the age of 10-12, it is important to visit the dentist regularly once every 3-4 months. After a year, you need to visit an orthodontist to make sure that the bite develops correctly.

List of sources

1. Zaplatnikov A. L., Kasyanova A. N.